4. Shanes JG, Stein heart catheterization
uber den zusammenhang zwischen risikofaktoren and letalitat bei aorto-koronaren venenbypass-operationen. Anoesfhesist 1986:35:184-186. 8. Kennedy JW. Kaiser CC, Fisher LD. Fritz JK, Myers W, Mudd JG, Ryan TJ. Clinical and angiographic predictors of operative mortality from the collaborative Circulation /98/,63:793-802. study in Coronary Artery Surgery (CA%). 9. Tobias J, Danahy D, Aronow W, Chetty K, Glauser F. Comparison of noninvasive with hemodynamic data in patients with pulmonary hypertension due to chronic obstructive pulmonary disease. Am J Med Sci /979;278;/9-25. 10. Conti R. Faxon D. Gruentzig A, Gunnar R, Lesch M, Reeves J. Task Force Ill: training in cardiac catheterization. JACC /986;7:/205-1206.
MA, Dierenfeldt BJ, Kondos GT. The value of routine right in patients undergoing coronary arteriography. Am Heart J
1987;113:1261-1263. 5. Barron JT, Rug&e N, Uretz E, Messer JV. Findings on routine right heart catheterization in patients with suspected coronary artery disease. Am Heart J
1988:115:l193-1198. 6. Dorros G, L&n
RF, Daley P, Assa J. Coronary artery bypass surgery in patients over age 70 years: report from the Milwaukee Cardiovascular Data Clin Cardiol 1987;10:377-382. Registry. 7. Krumholz W, Kling D, Boldt J, Muller H, Hempclmann G. Untersuchung
Electrophysiologic
Effects of Oral Theophylline
Paolo Alboni, MD, Paolo Rossi, and Gian Enrico Antonioli, MD
MD,
Benedetto Ratto,
heophylline is commonly used in the treatment of bronchial obstruction. In experimental studies the drug showed positive chronotropic effects.l,* During long-term therapy, oral theophylline suppressedsymptoms in young patients with paroxysmal bradyarrhythmias3;moreover,it diminished the frequency and severity of bradycardia in newborn infants with apnea-bradycardia.4 In someelectrophysiologicstudies intravenous theophylline showedimprovement in sinusnodal function.3,5 The mechanismby which the drug exertspositivechronotropic action is controversial. One study suggeststhat the primary effect of theophylline at therapeutic concentrations is antagonism of adenosinereceptors6 An increase in plasma catecholaminesin both normal subjects and patients with chronic obstructive pulmonary diseasehas also been shown after intravenous administration5; however, this investigation, to our knowledge, has not been carried out after oral therapy. The present study evaluates the effects of oral theophylline on sinus nodal function in patients with sinus bradycardia, and defines whether drug-induced improvement of sinus nodal function could be related to direct effects(or effectsmediated by nonautonomic receptors) or by autonomic actions. T
Electrophysiologic studies were performed in 15 patients (ages 67 f 10 years) with sinus brudycurdiu (sinus rate
uber den zusammenhang zwischen risikofaktoren and letalitat bei aorto-koronaren venenbypass-operationen. Anoesfhesist 1986:35:184-186. 8. Kennedy JW. Kaiser CC, Fisher LD. Fritz JK, Myers W, Mudd JG, Ryan TJ. Clinical and angiographic predictors of operative mortality from the collaborative Circulation /98/,63:793-802. study in Coronary Artery Surgery (CA%). 9. Tobias J, Danahy D, Aronow W, Chetty K, Glauser F. Comparison of noninvasive with hemodynamic data in patients with pulmonary hypertension due to chronic obstructive pulmonary disease. Am J Med Sci /979;278;/9-25. 10. Conti R. Faxon D. Gruentzig A, Gunnar R, Lesch M, Reeves J. Task Force Ill: training in cardiac catheterization. JACC /986;7:/205-1206.
MA, Dierenfeldt BJ, Kondos GT. The value of routine right in patients undergoing coronary arteriography. Am Heart J
1987;113:1261-1263. 5. Barron JT, Rug&e N, Uretz E, Messer JV. Findings on routine right heart catheterization in patients with suspected coronary artery disease. Am Heart J
1988:115:l193-1198. 6. Dorros G, L&n
RF, Daley P, Assa J. Coronary artery bypass surgery in patients over age 70 years: report from the Milwaukee Cardiovascular Data Clin Cardiol 1987;10:377-382. Registry. 7. Krumholz W, Kling D, Boldt J, Muller H, Hempclmann G. Untersuchung
Electrophysiologic
Effects of Oral Theophylline
Paolo Alboni, MD, Paolo Rossi, and Gian Enrico Antonioli, MD
MD,
Benedetto Ratto,
heophylline is commonly used in the treatment of bronchial obstruction. In experimental studies the drug showed positive chronotropic effects.l,* During long-term therapy, oral theophylline suppressedsymptoms in young patients with paroxysmal bradyarrhythmias3;moreover,it diminished the frequency and severity of bradycardia in newborn infants with apnea-bradycardia.4 In someelectrophysiologicstudies intravenous theophylline showedimprovement in sinusnodal function.3,5 The mechanismby which the drug exertspositivechronotropic action is controversial. One study suggeststhat the primary effect of theophylline at therapeutic concentrations is antagonism of adenosinereceptors6 An increase in plasma catecholaminesin both normal subjects and patients with chronic obstructive pulmonary diseasehas also been shown after intravenous administration5; however, this investigation, to our knowledge, has not been carried out after oral therapy. The present study evaluates the effects of oral theophylline on sinus nodal function in patients with sinus bradycardia, and defines whether drug-induced improvement of sinus nodal function could be related to direct effects(or effectsmediated by nonautonomic receptors) or by autonomic actions. T
Electrophysiologic studies were performed in 15 patients (ages 67 f 10 years) with sinus brudycurdiu (sinus rate
